Recommendation F199: Key nurses
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
Each patient should be allocated for each shift a named key nurse responsible for coordinating the provision of the care needs for each allocated patient. The named key nurse on duty should, whenever possible, be present at every interaction between a doctor and an allocated patient.
In brief (written by this site)
In February 2026, the Department of Health and Social Care and NHS England reported, in commentary submitted in September 2024, that the named nurse model of care is used across the NHS to ensure safe and effective inpatient care (DHSC and NHS England, Feb 2026). The Thirlwall Inquiry legal team noted in May 2024 that although the government accepted the recommendation and professional guidance was published in 2014, having a named nurse was not made a mandatory requirement (The Thirlwall Inquiry legal team, May 2024).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026. The record below is the sources' own words.
About this summary
This recommendation applies across many organisations. The record reflects central policy activity; adoption in individual organisations may vary.
Government response
Accepted.
The Secretary of State for Health announced his support for patients having a named nurse in July 2013 and we are working with NHS England to support the delivery of this aim.
As The Inquiry made clear, organisations can take local action on this issue, and we are pleased that some organisations, such as University College London Hospitals NHS Foundation Trust, already have a system of named nurses. Where named nurses have been implemented, this should be evaluated so that lessons can be learnt and good practice shared.
At a seminar hosted by the Academy of Medical Royal Colleges on 25 September 2013, it was clear there is professional consensus around the issue of named clinicians, and the Academy is leading work to take this forward. The Academy will produce key principles with worked examples on how this can be implemented in a way that sustains professional support.
How this response relates to the recommendation
Site note: This is volume two of "Hard Truths: The Journey to Putting Patients First" (Cm 8777-II), the government's response to the Inquiry's 290 recommendations, published by the Department of Health on GOV.UK on 19 November 2013 and dated to that day here. The PDF the row links to is the accessible edition, whose title page reads "January 2014". The Department of Health has been the Department of Health and Social Care since January 2018. The volume says it includes accounts from each of the national organisations the recommendations name, but it does not mark which passage each organisation wrote, so every row is filed under the Department that published it.
Blanket government agreement does not establish acceptance or delivery by each addressee. Some response passages cover groups of recommendations.
Scope of the government response
Government responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.
Delivery
DHSC and NHS England say in progress (27 February 2026)
The named nurse has the responsibility to ensure the actual delivery of safe and effective care during a patient’s inpatient stay. This has been achieved by having a clear understanding role of the Named Nurse, as well as the competencies to be able to deliver the interventions.
This model of care is used by the NHS. It is different to the role of the Designated Nurse for Looked after Children.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented - Ongoing”. Table row: section 18.2 No. 199, PDF page 526.
Department of Health and Social Care says in progress (11 February 2015)
The Academy of Royal Colleges published Guidance for Taking Responsibility: Accountable Clinicians and Informed Patients in June 2014. This provides guidance on how responsible clinicians and named nurses can be implemented in practice.
Site note: This is the supporting annex published on 11 February 2015 with "Culture change in the NHS: applying the lessons of the Francis Inquiries" (Cm 9009), attached to the GOV.UK page as "Culture change in the NHS supporting annex". The annex has no title page; that title is GOV.UK's and the PDF's own. Its table has four columns (No., Recommendation, Hard Truths Government response, Progress update), and the row carries the Progress update cell. No column says which organisation wrote an update, so the row is filed under the Department of Health (now the Department of Health and Social Care), which published it.
Site note: The Inquiry addressed this recommendation to healthcare providers, not to the Department of Health. The annex gives this update in the Department's publication and does not say who wrote it, so the row is the Department's report of the progress made on it.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
This recommendation was accepted by the Government.
The Secretary of State for Health announced his support for patients having a named nurse in July. It was not made a mandatory requirement.
The Academy of Medical Royal Colleges was asked by the Government to produce guidance on the issue, which it published in June 2014.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 16.2 No. 199, PDF page 489.
Source
Responsible bodies
Themes and tags
Who has spoken
- Department of Health and Social Care
Response, delivery statement - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding